Prostate Cancer

Patients with high-risk, nonmetastatic prostate cancer saw no survival advantage and no delay in metastases with the addition of adjuvant docetaxel to androgen deprivation therapy (ADT), a randomized trial found. With a median follow-up of over 10 years, the time to radiologic progression was 8.9 years for ADT plus docetaxel compared with 9.0 years for ADT alone (HR 1.03, 95% CI 0.74-1.43) in a patient population with androgen-dependent disease, according to researchers led by Stéphane Oudard, MD, PhD, of Georges Pompidou Hospital in France. Based on these results, "docetaxel may not be as suitable in a high-risk setting as in a metastatic setting," they concluded in JAMA Oncology . Patients assigned to adjuvant docetaxel had a non-significant 15% improvement in prostate-specific antigen (PSA) relapse, the study's primary endpoint. With a median follow-up of 30.0 months, the median PSA progression-free survival was 20.3 months for the combination arm compared with 19....

January 31, 2019 Share this content: Androgen deprivation therapy recipients had a significantly lower risk for autoimmune diseases overall and for Graves’ disease, uveitis, and psoriasis. Androgen deprivation therapy (ADT) for prostate cancer (PCa) may reduce the risk of developing autoimmune diseases, according to a new report. In a study of men with PCa identified using the National Health Insurance Research Database of Taiwan, Ren-Jun Hsu, MD, PhD, of the National Defense Medical Center in Taiwan, and colleagues matched 5590 ADT users with 5590 non-ADT users by propensity score. ADT users received gonadotropin-releasing hormone agonists, oral antiandrogens, or estrogens. ADT recipients younger than 40 years or with a history of autoimmune disease were excluded from analyses. Continue Reading Below Patients who received ADT had a significant 38% decreased risk for autoimmune disease compared with those who did not, in adjusted analyses, investigators reported in Prostate...

OWINGS MILLS, Md. , Jan. 31, 2019 /PRNewswire/ -- Ultrasound is having its day in the spotlight as new technology is providing the ability to use sound waves to destroy prostate cancer cells. High Intensity Focused Ultrasound (HIFU) is now being utilized by the specialists at Chesapeake Urology as an exciting new, minimally invasive treatment for localized prostate cancer (cancer that has not spread outside of the walls of the prostate). HIFU uses ultrasound energy, or sound waves, to heat and destroy specifically targeted areas of cancerous tissue in the prostate.  "New therapies to combat prostate cancer are continuously emerging and HIFU has many significant benefits for our patients," said Anup Vora , Director of the Ablative and Focal Therapy Program for Prostate Cancer at Chesapeake Urology. "With HIFU, our specially trained physicians have the ability to target and treat the affected prostate tissue, minimizing damage to areas around the prostate. This helps pr...

LOS ANGELES – JANUARY 31, 2019 As Valentine’s Day approaches, spice up your life while supporting the fight against prostate cancer.  Fuego Box , purveyors of small-batch/craft hot sauces delivered to your door monthly, is teaming up with the Prostate Cancer Foundation (PCF) on The Choco Challenge™, the world’s spiciest mini chocolate bar. People around the country are taking the challenge and experiencing the intense heat of the unreleased Black Reaper™ pepper, all while supporting prostate cancer research. Visit  http://www.chocochallenge.com  to purchase The Choco Challenge bar. For every bar sold, Fuego Box will donate $5.00 to prostate cancer research. Once you’ve built up the courage to unwrap the chocolate bar – attempt to eat it, film it, and share it publicly on social media with the tag @fuegobox and #ChocoChallenge2019 for a chance to win a YEAR of hot sauce. Entries can also be emailed to choco(at)fuegobox.com. Be warned though, this is extremely ...

[embedded content] In addition to research focused on patients in the metastatic hormone-sensitive setting as well as those in biochemical recurrence, efforts are being made with a specific focus on providing patients with more durable remissions without sacrificing quality of life. As this is a longer-term disease process, says Dorff, many of the newer studies are recording patient-reported outcomes, which is very important. Immunotherapy is another area of opportunity although immune checkpoint inhibitors have not shown as substantial of a benefit in these patients as physicians would like. Sipuleucel-T (Provenge) is a form of immunotherapy that has demonstrated benefit, although modest in men with prostate cancer. Physicians are hoping that more research will lead to a game-changing immunotherapy for this patient population. Studies are underway in which investigators are evaluating combinations of radiation with immunotherapy, immunotherapy with immunotherapy, as well as explor...

Apalutamide (Erleada) in combination with androgen deprivation therapy (ADT) was found to significantly improve radiographic progression-free survival (rPFS) and overall survival (OS) versus placebo in patients with metastatic castration-sensitive prostate cancer, according to topline findings of the phase III TITAN trial (NCT02489318). 1 Due to these preplanned data, along with a recommendation by an Independent Data Monitoring Committee, Janssen, the manufacturer of the next-generation androgen receptor (AR) inhibitor, unblinded the study. Based on the positive data with apalutamide, the committee recommended that patients on the placebo plus ADT arm be permitted to cross over to the apalutamide group. Patients will continue to be followed for OS and long-term safety as part of TITAN.  “The TITAN study was designed to evaluate the efficacy and safety of Erleada in combination with androgen deprivation therapy in patients with newly diagnosed metastatic castration-sensitive pro...

In topline findings from the phase III TITAN trial (NCT02489318) announced today by Janssen, apalutamide (Erleada) in combination with androgen deprivation therapy (ADT) significantly improved radiographic progression-free survival (rPFS) and overall survival (OS) versus placebo in patients with metastatic castration-sensitive prostate cancer. The study has been unblinded based on these preplanned data, along with a recommendation by an Independent Data Monitoring Committee. The committee recommended that patients on the placebo plus ADT arm be permitted to cross over to the apalutamide group. Patients will continue to be followed for OS and long-term safety as part of TITAN.  “The TITAN study was designed to evaluate the efficacy and safety of Erleada in combination with androgen deprivation therapy in patients with newly diagnosed metastatic castration-sensitive prostate cancer, regardless of the extent of their disease,” said Margaret Yu, MD, vice president, Oncology...

Patients with high-risk, nonmetastatic prostate cancer saw no survival advantage and no delay in metastases with the addition of adjuvant docetaxel to androgen deprivation therapy (ADT), a randomized trial found. With a median follow-up of over 10 years, the time to radiologic progression was 8.9 years for ADT plus docetaxel compared with 9.0 years for ADT alone (HR 1.03, 95% CI 0.74-1.43) in a patient population with androgen-dependent disease, according to researchers led by Stéphane Oudard, MD, PhD, of Georges Pompidou Hospital in France. Based on these results, "docetaxel may not be as suitable in a high-risk setting as in a metastatic setting," they concluded in JAMA Oncology . Patients assigned to adjuvant docetaxel had a non-significant 15% improvement in prostate-specific antigen (PSA) relapse, the study's primary endpoint. With a median follow-up of 30.0 months, the median PSA progression-free survival was 20.3 months for the combination arm compared with 19....

Biographies: Mary-Ellen Taplin, MD Chair, Executive Committee for Clinical Research Director of Clinical Research, Lank Center for Genitourinary Oncology Institute Physician, Dana-Farber Cancer Institute Professor of Medicine, Harvard Medical School Alicia Morgans, MD, MPH , Associate Professor of Medicine in the Division of Hematology/Oncology at the Northwestern University Feinberg School of Medicine in Chicago, Illinois. http://bit.ly/2UCi6ZR

Magnetic resonance imaging (MRI) is currently the most accurate imaging modality to assess local prostate cancer stage. Despite a growing body of evidence, incorporation of MRI images into decision-making process concerning surgical template of radical prostatectomy, is complex and still poorly understood. We sought to determine the value of MRI in preoperative planning before radical prostatectomy. Systematic search through electronic PubMed, EMBASE, and Cochrane databases from 2000 up to April 2018 was performed. Only studies that used preoperative MRI in decision-making process regarding extension of resection in patients with prostate cancer, in whom radical prostatectomy was an initial form of treatment were included into analysis. Their quality was scored by Risk Of Bias In Non-Randomized Studies of Interventions system. Meta-analysis was performed to calculate the weighted summary proportion under the fixed or random effects model as appropriate and pooled effects were depicte...

Dear Mr. Berko: My husband of 34 years is a retired Marine colonel with prostate cancer, and the doctors told him that it is aggressive and could metastasize. I know that you know a lot about prostate cancer because you mentioned at a lecture in Gainesville that Johnson & Johnson had a new drug to treat prostate cancer. You told us your son, who is a doctor, keeps up on the latest treatments. Is there anything new that you could share with us? — RS, Gainesville, Fla. Dear RS: I'm told prostate cancer is the second-most common cancer in men. Last year in the U.S., over 164,000 cases were reported, and so were about 29,000 deaths. Worldwide, according to the American Cancer Society, there are 1.1 million new cases annually and 310,000 deaths. That's a lot of potential pills. Meanwhile, the two pill companies your doctor should peruse are Johnson & Johnson and Pfizer. Each has a new prostate cancer drug coming out soon, and each is a company I'd recommend, in a Minne...

A randomized phase 3 trial designed to evaluate the addition of apalutamide to androgen deprivation therapy for men with metastatic castration-sensitive prostate cancer has been unblinded at the recommendation of an independent data monitoring committee. The committee made its recommendation after a preplanned analysis showed the TITAN study met its dual primary endpoints, demonstrating significantly improved radiographic PFS and OS among men assigned apalutamide (Erleada, Janssen) plus ADT compared with those assigned placebo plus ADT. The committee’s recommendation allows men assigned placebo plus ADT to cross over to treatment with apalutamide plus ADT. Follow-up for OS and long-term safety will continue. Apalutamide — an androgen receptor inhibitor — is approved for treatment of nonmetastatic castration-resistant prostate cancer. “We look to continue to build upon our understanding of Erleada for patients with metastatic prostate cancer, as there remains a significant unmet ne...

Apalutamide (Erleada) in combination with androgen deprivation therapy (ADT) was found to significantly improve radiographic progression-free survival (rPFS) and overall survival (OS) versus placebo in patients with metastatic castration-sensitive prostate cancer, according to topline findings of the phase III TITAN trial (NCT02489318). 1 Due to these preplanned data, along with a recommendation by an Independent Data Monitoring Committee, Janssen, the manufacturer of the next-generation androgen receptor (AR) inhibitor, unblinded the study. Based on the positive data with apalutamide, the committee recommended that patients on the placebo plus ADT arm be permitted to cross over to the apalutamide group. Patients will continue to be followed for OS and long-term safety as part of TITAN.  “The TITAN study was designed to evaluate the efficacy and safety of Erleada in combination with androgen deprivation therapy in patients with newly diagnosed metastatic castration-sensitive pro...

SPRING HOUSE, Pa., Jan. 30, 2019 /PRNewswire/ -- The Janssen Pharmaceutical Companies of Johnson & Johnson announced today the unblinding of the Phase 3 TITAN study  evaluating ERLEADA ® (apalutamide) plus androgen deprivation therapy (ADT) in the treatment of patients with metastatic castration-sensitive prostate cancer (mCSPC). The decision resulted from an Independent Data Monitoring Committee (IDMC) recommendation coinciding with a pre-planned analysis that showed the dual primary endpoints were both achieved, significantly improving radiographic progression-free survival (rPFS) and overall survival (OS). Based on these results, the IDMC recommended that patients in the placebo plus ADT group be given the opportunity to cross over to treatment with ERLEADA plus ADT. Patients will continue to be followed for OS and long-term safety as part of the TITAN study. "The TITAN study was designed to evaluate the efficacy and safety of ERLEADA in combination with androgen dep...

The clinical course in patients with prostate cancer (PCa) after biochemical failure (BF) has received limited attention. This study analyzes survival time from recurrence, patterns of progression, and the efficacy of salvage therapies in patients treated with radical or postoperative radiotherapy (RT). This is a multicenter retrospective comparative study of 1135 patients diagnosed with BF and treated with either radical (882) or postoperative (253) RT. Data correspond to the RECAP database. Clinical, tumor, and therapeutic characteristics were collected. Descriptive statistics, survival estimates, and comparisons of survival rates were calculated. Time to BF from initial treatment (RT or surgery) was higher in irradiated patients (51 vs 37 months). At a median follow-up of 102 months (14-254), the 8-year cause-specific survival (CSS) was 80.5%, without significant differences between the radical (80.1%) and postoperative (83.4%) RT groups. The 8-year metastasis-free surviv...

28 January 2019 08:19 Analysis looked at survival rates between 2006 and 2016 The five-year survival rate for patients with breast, prostate and bowel cancer has barely improved over the last decade, new figures suggest. Analysis by the Office for National Statistics (ONS) found survival for these cancers - newly-diagnosed in more than 100,000 people in the UK every year - have remained fairly static. But it's better news for other cancers, with lung, kidney and myeloma all showing much bigger improvements in five-year survival rates. Latest stats ONS stats show breast cancer five-year survival was 83.6% for the years 2006-2010, rising slightly to 85.6% in the years 2009-2013, before dropping to 85% and then sticking at 85.3% in 2012-16. Prostate cancer survival has also risen slightly, with five-year survival at 84.9% in 2006-2010, before reaching 87.1% in 2012-16. Macmillan Cancer support said it was "concerning to see that five-year survival rates for some of th...

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January 29, 2019 Share this content: Men with unfavorable-risk prostate cancer who had a detectable PSA nadir and a time to PSA nadir less than 12 months had a 5-fold increased risk of dying from their disease. Men with a short time to PSA nadir (TTN) and a detectable PSA nadir following external beam radiation treatment (EBRT) with or without androgen deprivation therapy for unfavorable-risk prostate cancer are at elevated risk of dying from their cancer, investigators concluded. Among men with a detectable PSA nadir (0.2 ng/mL or higher), those with a TTN less than the median of 12 months had a significant 5-fold increased risk of cancer-specific death in adjusted analyses than men who had a TTN of 12 months or more, according to study findings published in Urology . Investigators did not observe this association among men with an undetectable PSA nadir (less than 0.2 ng/mL). Continue Reading Below The finding could have important disease management implications. “We are ...

Several systemic therapeutic options exist for metastatic castrate-sensitive prostate cancer (mCSPC). Circulating tumor DNA (ctDNA) can molecularly profile metastatic castration-resistant prostate cancer and can influence decision-making, but remains untested in mCSPC. To determine ctDNA abundance at de novo mCSPC diagnosis and whether ctDNA provides complementary clinically relevant information to a prostate biopsy. We collected plasma cell-free DNA (cfDNA) from 53 patients newly diagnosed with mCSPC and, where possible, during treatment. Targeted sequencing was performed on cfDNA and DNA from diagnostic prostate tissue. The median ctDNA fraction was 11% (range 0-84%) among untreated patients but was lower (1.0%, range 0-51%) among patients after short-term (median 22d) androgen deprivation therapy (ADT). TP53 mutations and DNA repair defects were identified in 47% and 21% of the cohort, respectively. The concordance for mutation detection in matched samples was 80%. Combined ctDNA...

Low-dose aspirin use has been correlated with an increased risk of bleeding and overall complications in surgical and invasive diagnostic procedures. In this review, our aim was to analyze the current literature on whether robot-assisted radical prostatectomy (RARP) is feasible and safe in patients taking low-dose aspirin perioperatively. A systematic review was performed identifying a total of 767 studies, published between January 2000 and September 2017, with five of these studies meeting the inclusion criteria for the meta-analysis, totalizing 1481 patients underwent RARP. Patients were divided into two groups: taking aspirin (group A) and those not taking aspirin (group B) perioperatively. There were no significant differences between groups in the overall [group A 10.7% versus group B 15.7%, risk ratio (RR) 0.83; p = 0.45; I2 = 0%] or major complication rates (group A 1% versus group B 3%, RR 0.98; p = 0.98; I² = 0%), rate of cardiovascular events (group A 1.4% and group B 0.5%...

January 29, 2019 This article originally appeared on Renal and Urology News. Share this content: Compared with men receiving androgen deprivation therapy for prostate cancer, healthy men had a 98% decreased risk of overactive bladder, study finds. Androgen deprivation therapy (ADT) for prostate cancer is associated with an increased risk of overactive bladder (OAB), a finding consistent with an inhibitory role of androgen in modulating male voiding dysfunction, according to a new study. Compared with ADT recipients, healthy men and men receiving alpha blockers for benign prostatic hyperplasia (BPH) had a significant 98% and 30% decreased risk of OAB, respectively, after adjusting for numerous potential confounding factors. Increased ADT duration increased the cumulative risk of OAB. Continue Reading Below “Since ADT is still the pivotal treatment in advanced prostate cancer, OAB which might occur after ADT should be taken into consideration during patient care,” a team le...

Men weighing treatment options for intermediate- or high-risk cancer that is still localized to the prostate can face a tricky question. A standard approach in these cases is to give radiation to the prostate along with drugs that block testosterone, a hormone that makes the cancer cells grow faster. For how long should this hormone therapy last? That’s not entirely clear. The drugs have side effects, such as fatigue, impotence, and a loss of muscle mass. But radiation doesn’t control prostate cancer effectively without them. Doctors therefore aim to give hormone therapy only for as long as it takes to help their patients, without causing any undue harm. Now, newly published results from a phase 3 clinical trial are providing some needed guidance . How the study was performed During the study, scientists randomized 1,071 men with intermediate- or high-risk localized prostate cancer into four groups. One group received radiation and six months of an anti-testosterone drug called leup...

Men weighing treatment options for intermediate- or high-risk cancer that is still localized to the prostate can face a tricky question. A standard approach in these cases is to give radiation to the prostate along with drugs that block testosterone, a hormone that makes the cancer cells grow faster. For how long should this hormone therapy last? That’s not entirely clear. The drugs have side effects, such as fatigue, impotence, and a loss of muscle mass. But radiation doesn’t control prostate cancer effectively without them. Doctors therefore aim to give hormone therapy only for as long as it takes to help their patients, without causing any undue harm. Now, newly published results from a phase 3 clinical trial are providing some needed guidance . How the study was performed During the study, scientists randomized 1,071 men with intermediate- or high-risk localized prostate cancer into four groups. One group received radiation and six months of an anti-testosterone drug called leup...